Background: Few studies have been published on new-onset geriatric epilepsy especially in older Chinese people. This study was to have a comprehensive understanding of new-onset geriatric epilepsy and find a more reasonable diagnosis and management of epilepsy in older people.
Methods: One hundred and three patients with onset age 60 years and older were admitted between January 2008 and December 2016. Electronic medical records were reviewed to collect information.
Results: There were 103 older patients with new-onset epilepsy. The mean age of the patients was 68.5 ± 6.4 years (range: 60-89 years), and there were 67 (65%) men and 36 (35%) women. The mean onset age was 67.9 ± 6.2 years (range: 60-89 years). The most common identifiable etiology of symptomatic seizures was autoimmune epilepsy in 43 (41.7%) patients. The second most common etiology was stroke in 15 (14.6%) patients. Seven (6.8%) older patients with acute seizures present with status epilepticus and 26 (25.2%) patients experienced clustered seizures (more than three events in 24 h) at seizure onset. Focal seizures (96.1%) were more common than generalized seizures (3.9%). Fifty-three (51.5%) patients had an abnormal brain magnetic resonance imaging (MRI) scan. Among them, video-electroencephalogram findings in 31 (30.1%) patients correlated with MRI abnormalities. Levetiracetam was the most used drugs before admission, in hospital, and during follow-up.
Conclusions: Autoimmune encephalitis is becoming an increasing risk factor of subsequent epilepsy in older people. Older patients with new epilepsy are more likely to respond to antiepileptic drugs, and drug-resistant epilepsy is uncommon.
中国人群新发老年癫痫：一项单中心研究 摘要 背景: 中国人群新发老年癫痫的研究报道较少。本研究的目的是全面了解中国人群新发老年癫痫，以便对其更好地诊断及治疗。 方法: 2008年1月至2016年12月期间收入院的所有发病年龄大于等于60岁的老年癫痫患者，回顾分析其临床资料。 结果: 共103例患者为新发老年癫痫。平均入院年龄为68.5±6.4岁 (范围: 60-89 岁) ，其中男性67例 (65%) ，女性36例 (35%)。平均发病年龄 67.9±6.2 岁 (范围: 60-89 岁)。 症状性癫痫最常见病因为自身免疫性癫痫，共43例 (41.7%) 患者。第二大常见病因是卒中，共15例 (14.6%) 患者。新发急性老年癫痫患者中7例 (6.8%) 经历了癫痫持续状态，26例 (25.2%) 患者起病时经历了丛集发作 (24小时发作次数大于3次) 。局灶性癫痫 (96.1%) 比全面性癫痫 (3.9%) 更常见。 53例 (51.5%) 患者头颅核磁共振异常。其中，31例 (30.1%) 患者视频脑电结果与核磁共振异常一致。左乙拉西坦是老年癫痫人群中，包括入院前、住院时及出院后随访期间最常用的抗癫痫药物。 结论: 自身免疫性脑炎正成为老年人群癫痫的一大危险因素。新发的老年癫痫患者对抗癫痫药物疗效反应较好，难治性癫痫不常见。.
Keywords: Elderly; Electroencephalography; Epilepsy; Seizures.